Get the free Mid-Year Change Form - Health Care & Benefits Division - benefits mt
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MIDYEAR CHANGE FORMINSTRUCTIONS & DEADLINE FOR ELECTIONS Use this form to make midyear changes to your State of Montana Benefit Plan (State Plan) coverage. This form and the appropriate verification
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What is mid-year change form?
The mid-year change form is a document used to make changes to benefits enrollment outside of the open enrollment period.
Who is required to file mid-year change form?
Employees who experience a qualifying life event, such as marriage, birth of a child, or change in employment status, are required to file a mid-year change form.
How to fill out mid-year change form?
To fill out a mid-year change form, you will need to provide information about the qualifying life event, the changes you wish to make to your benefits, and any supporting documentation.
What is the purpose of mid-year change form?
The purpose of the mid-year change form is to allow employees to adjust their benefits coverage outside of the regular open enrollment period when a qualifying life event occurs.
What information must be reported on mid-year change form?
The mid-year change form must include details about the qualifying life event, the effective date of the changes, and any supporting documentation required to make the changes.
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